Conversion Disorder

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KEY POINTS

• Conversion disorder is a term used when your child has physical symptoms that seem to be caused by problems in the nervous system, but which are not caused by a physical disease or disorder of your child’s brain, spine, or nerves. Often the symptoms start after a stressful experience.
• Conversion disorder may be treated with therapy, medicine, or both.
• Ask your child if they are feeling suicidal or have done anything to hurt themselves. Get emergency care if your child has ideas of suicide or harming others or themselves.

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What is conversion disorder?

Conversion disorder is a term used when your child has physical symptoms such as paralysis, seizures, or blindness that seem to be caused by problems in the nervous system, but which are not caused by a physical disease or disorder of your child’s brain, spine, or nerves. Your child’s symptoms may keep him from going to school or doing everyday activities.

It may also be called functional neurological disorder.

What is the cause?

The exact cause of this disorder is not known. Often the symptoms start suddenly after a physically or emotionally stressful experience. For example, sudden blindness after seeing a terrible accident, even though there is nothing wrong with your child’s eyes or the part of the brain that controls vision. It is thought that the brain may process emotions in a different way, so that instead of expressing extreme fear or anger, your child may have symptoms in his body. The symptoms are real, and not something that your child does on purpose.

Conversion disorder is most common in children over 10 years old. The risk is greater if your child:

• Sees or is involved in a stressful event, such as a natural or man-made disaster
• Has a family member with the disorder
• Has been physically or sexually abused or neglected
• Lives in a family that has financial or housing problems
• Has problems at school
• Is female
• Is around people who have physical symptoms

What are the symptoms?

The symptoms start suddenly. Symptoms may include:

• Weakness or not being able to move an arm or leg
• Numbness or changes in the way things feel to touch
• Vision changes, such as double vision or blindness
• Hearing problems or deafness
• Not being able to speak or having slurred speech
• Seizures or falling down
• Severe trembling
• Balance problems or trouble walking
• Trouble swallowing

How is it diagnosed?

Your child's healthcare provider will ask about the child's symptoms, medical and family history, and any medicines your child is taking. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. Your child may have tests or scans to check for other possible causes of the symptoms.

How is it treated?

Sometimes conversion disorder gets better without treatment. If symptoms are serious or last longer than a few days, treatment may include therapy, medicine, or both.

Therapy

• Cognitive behavioral therapy (CBT) is a way to help your child identify and change views he has of himself, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help your child learn new ways to think and act.
• Group therapy can help your child deal with work or school and relationships. It takes place in a group of 6 to 10 people, under the guidance of a therapist.
• Family therapy is often very helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.
• Physical therapy and occupational may be helpful if your child has weakness, paralysis, or trouble moving his body.
• Speech therapy may be helpful if your child trouble talking or swallowing.

Medicine

• There are no medicines known to treat conversion disorder. Medicine may be prescribed if your child also has problems with anxiety or depression. Your child’s healthcare provider will work with you to select the best medicine for your child. Your child may need to take more than one type of medicine.

Other treatments

• Learning ways to relax may help. Yoga and meditation may be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and therapy. Physical therapy may be needed until symptoms go away. PT may help keep a paralyzed arm or leg strong.
• Hypnosis may be helpful in treating this disorder.

How can I help take care of my child?

• Support your child. Encourage your child to talk about whatever they want to talk about. Be a good listener. This helps your child know that his feelings and thoughts really do matter, that you truly care about him, and that you never stop caring. If your child shuts you out, let your child know that you are there for him whenever he needs you. Remind your child of this over and over again.

  Stay in touch with teachers, babysitters, and other people who care for your child to share information about symptoms your child may be having.

• Be consistent. Understand that you are not responsible for your child's anxiety, even if something such as a divorce may be involved. Be firm and consistent with rules and consequences. Your child needs to know that the rules still apply to them. It does not help to teach children that they can avoid consequences if they’re anxious or if they act out.
• Help your child learn to manage stress. Teach your child to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax. For example take up a hobby, listen to music, play, watch movies, or take walks.
• Take care of your child’s physical health. Make sure your child eats a healthy diet and gets enough sleep and exercise every day. Teach your child to avoid alcohol, caffeine, nicotine, and drugs.
• Check your child’s medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that your child takes. Make sure your child takes all medicines as directed by your provider or therapist. It’s very important for your child to take their medicine even when feeling and thinking well. Without the medicine, your child’s symptoms may not improve or may get worse. Talk to your provider if your child has problems taking the medicine or if the medicine doesn't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your child’s symptoms seem to be getting worse.

Ask your child if they are feeling suicidal or have done anything to hurt themselves. Get emergency care if your child has ideas of suicide or harming others or themselves.

You can get more information from:

• National Institute of Mental Health
  866-615-6464
  https://www.nimh.nih.gov/index.shtml
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/